Internal Medicine Careers

Attracting more medical students to choose a career in primary care is crucial for the future of the health care system. Any future primary care physicians will emerge from the ranks of internal medicine residents, so it’s instructive to learn what motivates their selection to specialize or not.

An analysis published in the Annals of Internal Medicine compares results of a large national survey of Internal Medicine residents from 1990 and 2007. The proportions of respondents who wanted to pursue a career in internal medicine were nearly identical in the two cohorts, but the share who wanted to go into primary care dropped from 9% to 2%.

Other changes in the cohort help explain this decrease. The 1990 respondents faced an average of $63,000 in educational debt while the 2007 group had an average of $101,000 in debt. The younger group was also more than half female, up from 37% in 1990.

The 2007 respondents saw internal medicine as a meaningful field, but were turned off by the work demands and low financial remuneration. The authors conclude that improving the residency experience will be insufficient to increase the numbers of physicians opting for careers in primary care.

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